Medical students should have more training in death certification because standards in Britain are "depressingly low", the former chair of the Shipman Inquiry said today.

Dame Janet Smith, who led the inquiry into how Harold Shipman managed to murder up to 250 people while practising as a doctor, said that students can only have half an hour's training in certification despite it being "hugely important".

Death certificates are not just documents that end up in a vault somewhere and students should be taught their value, Dame Janet told the General Medical Council's conference on medical education in London.

Since chairing the Shipman Inquiry and investigating how one of the world's most prolific serial killer's was not detected by the authorities, certification had become a "bit of a hobby horse of mine", the judge admitted.

Depressing

She said: "During the Shipman Inquiry, I looked into the research that has been done into the standards of death certification in this country. They are depressingly low.

"Research shows a high level of mistakes made by certifiers of all levels of doctors, from housemen to consultants and including GPs.

"The same research suggests that there are some ethical issues involved.

"Some doctors seem to think that it is acceptable to bend the rules on reporting a death to the coroner to save a family the stress of an inquest.

"There seems to be a poor understanding of the importance of accurate death certification. It isn't just a certificate that goes into a vault somewhere tucked away.

"The figures and information that comes from this certification inform a great number of important issues, public health issues, resource dispensing issues. It is hugely important.

"At the inquiry, I was told that this country's medical students might receive half an hour's training on death certification. Perhaps that explains the poverty of standard."

Dame Janet added that a doctor from Finland who gave evidence at the inquiry told them students there receive several hours of training.

"I think it was seven hours and the certificates I saw from there were of a very high standard.

"We need better training in this, including training in some understanding of the purposes behind certification and the purposes to which it is put," she said.

Medical training should also be more focused on conduct and morals in the future, the judge said, suggesting that students should have to pass an exam on medical ethics to ensure the public interest would be protected when they became doctors.

Ethics

She said: "You might consider how best to test people's understanding of their ethical responsibility.

"It would be sensible to have some means of weeding out and failing students who have not managed to catch on to and absorb the essential ethical principles which they would be expected to practice throughout their career.

"I would like to see it as a fundamental and important part, to be tested with the potential of failure."

Dame Janet told the conference: "I know you will say you already have to put a quart into a pint pot, but I say that you have to decide on your priorities.

"I would say that knowledge and skills can be enlarged and enhanced as you progress through your professional life but ethics and attitudes are fundamental and have to be planted right at the beginning."